RESUMO
BACKGROUND/AIMS: The aims of this study were to validate the prognostic value of the JIS score for HCC and to compare discriminatory ability and predictive power with other staging systems such as Okuda, TNM and CLIP. METHODS: We analyzed the clinical records of 210 patients who were diagnosed as HCC from 2000 to 2002. Univariate and multivariate survival analyses were done to find out factors to affect survival. To validate prognostic value of those staging systems, survival curve was obtained and analyzed by the Kaplan-Meier's method, and to compare discriminatory ability and predictive power, Homogeneity LR chi-square test and AIC score were used. RESULTS: The median survival was 19.5 months (19.1+/-14.9). The number of patients and 3-year survival rate for those staging systems were Okuda 1(126, 57.7%), 2(63, 9.0%) and 3(21, 0.0%) (p<0.001); TNM I (34, 63.1%), II (71, 59.4%), III (50, 22.4%), IV-A (6, 14.3%) and IV-B (1, 6.5%) (p<0.001); CLIP 0 (79, 68.5%), 1 (39, 34.2%), 2 (36, 16.7%), 3 (25, 20.0%), 4 (18, 5.1%), 5 (9, 11.1%) and 6 (4, 0.0%) (p<0.001) and JIS 0 (26, 78.9%), 1 (65, 65.3%), 2 (43, 21.9%), 3 (40, 25, 8.0%) and 5 (11, 2.0%)(p<0.001) in univariate analysis using Kaplan-Meier analysis. Homogeneity LR chi-square test showed more stratification power in JIS (Okuda, 102.8; TNM, 128.2; CLIP, 148.4 and JIS, 185.6) and AIC score showed superior predictive power in JIS system (Okuda, 1228.5; TNM, 1130.3; CLIP, 1117.1 and JIS, 1093.6). CONCLUSIONS: The proposed JIS system is useful system to predict survival of HCC patients. The discriminate ability of the JIS score is much better than other staging systems and has better prognostic predictive power compared to other staging systems.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Hepatocelular/mortalidade , Neoplasias Hepáticas/mortalidade , Análise Multivariada , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Índice de Gravidade de Doença , Análise de SobrevidaRESUMO
Splenic pseudocyst is a rare complication of abdominal trauma. Although it is rare, splenic pseudocyst is well-documented in the literature. According to the current classification, approximately 30% of all splenic cysts or pseudocysts result from direct abdominal trauma. In addition, chronic pancreatitis leads to change of nearby organs with possible acute and chronic complications including splenic lesions. This unusual complication can occur in both emergent and nonemergent conditions. The useful diagnostic procedures to assess intrasplenic pseudocyst are sonogram, CT scan, splenic scan, and occasionally angiography. However, definite diagnosis of pseudocyst is possible only after splenectomy when the absence of epithelial lining is confirmed histologically. Splenic pseudocyst requires surgical resection. We experienced a 31-year-old man who confirmed of warmness in the left side of back with left upper quadrant abdominal pain for several months. First impression was splenic lymphangioma based on CT scan and sonogram finding. Splenectomy was performed. Microscopic examination revealed splenic pseudocyst with fibrous capsule without epithelial lining.
Assuntos
Adulto , Humanos , Masculino , Cistos/diagnóstico , Diagnóstico Diferencial , Linfangioma/diagnóstico , Esplenectomia , Esplenopatias/diagnóstico , Neoplasias Esplênicas/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
We report the case of a 32-year-old woman who experienced stiffness and thickening of skin and Raynaud's phenomenon. Anti-nuclear antibody, anti-SSA antibody and anti-Scl 70 antibody were positive. Clinical manifestations and laboratory investigations were appropriate to systemic sclerosis (SSc). The patient was also diagnosed as Bormann type III advanced gastric cancer on gastrofiberoscopy. Several reports suggested the association of SSc with various malignant carcinomas. They noted that the most frequent types were lung cancer and skin cancer. Stomach cancer was rarely reported in association with systemic sclerosis. The association between SSc and gastric cancer is not clear, but several mechanisms are proposed in several studies.
Assuntos
Adulto , Feminino , Humanos , Neoplasias Pulmonares , Escleroderma Sistêmico , Pele , Neoplasias Cutâneas , Neoplasias GástricasRESUMO
Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.
Assuntos
Humanos , Dor Abdominal , Alcoólicos , Diarreia , Fezes , Hospedeiro Imunocomprometido , Obstrução Intestinal , Larva , Hepatopatias Alcoólicas , Náusea , Parasitos , Strongyloides stercoralis , EstrongiloidíaseRESUMO
Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.